Enfermedad mitocondrial y ototoxicidad". Enfermedad mitocondrial sindrómica, mutación G7444A / Mitochondrial disease and ototoxicity

Como parte del programa de “screening” genético para la pérdida de la audición; se realizó el estudio de mutaciones en los genes rRNA 12S y tRNAser (UCN), a partir del DNA mitocondrial, que están asociadas con la pérdida de audición inducida por antibióticos aminoglucósidos (ATB-AG) y de presentación no sindrómica. Se estudiaron 40 pacientes con sorderaneurosensorial, la cual podría haber sido causada posterior al tratamiento con ATB-AG. El sujeto afectado y el control, luego del examen físico completo y extracción de DNA a partir de sangre periférica, se amplificó y estudió segmentos en el gen 12S rRNA y en el gen tRNAser (UCN) por PCR-RFLP. En presencia de una mutación, se analizó el genoma mitocondrial completo en el probando y su familia por línea materna. Estos resultadosse han correlacionado con los valores de la relación dela citocromo oxidasa / citrato sintasa, el cual indica unapobre actividad de la citocromo oxidasa. La clínica en el“pedigree” por línea materna y los estudios moleculares,bioquímicos y morfológicos, podría indicar que se tratade una presentación sindrómica de la mutación 7444G>Aen Córdoba - Argentina.

As part of the "screening" for genetic hearing loss,was performed to study mutations in 12S rRNA and tRNAser(UCN) genes from mitochondrial DNA, which are associatedwith hearing loss induced by antibiotics aminoglycosides(ATB-AG) and non-syndromic presentation. We studied40 patients with sensorineural hearing loss, which could have been caused subsequent to treatment with ATB - AG. The affected individual and control, after a completephysical examination and extraction of DNA fromperipheral blood, was amplified and studied segments inthe 12S rRNA and tRNAser (UCN) genes by PCR-RFLP. In the presence of a mutation, we analyzed the complete mitochondrial genome in the proband and his family from maternal line. These results werecorrelated with the values of the ratio of the cytochromeoxidase / citrate synthase, which indicates a poor activity of cytochrome oxidase. The clinic in the "pedigree" frommaternal line and molecular, biochemical and morphological might indicate that it is a syndromic presentation of the mutation 7444G> A in Córdoba - Argentina.

Obstructive uropathy as the only manifestation of flare in a patient with systemic lupus erythematosus and anti-phospholipid syndrome.

Chronic interstitial cystitis and ureteral stenosis has occasionally been reported in systemic lupus erythematosus, mostly associated with gastrointestinal symptoms. We report a case of obstructive uropathy associated to chronic interstitial cystitis as the only manifestation of lupus flare in a patient with SLE and anti-phospholipid syndrome (APS) who had been in remission for many years. The development of chronic interstitial cystitis in patients with SLE and APS has not been previously reported. Histopathological study of her urinary bladder and ureteral meatus showed chronic inflammatory infiltrate in the subepithelium. Lack of significant lower urinary tract symptoms and gastrointestinal involvement were some of the factors that could have prevented an earlier diagnosis. Obstructive uropathy and renal insufficiency initially improved with immunosuppressive treatment and endoureteral protheses, but poor compliance to the therapy led to ominous ending.

[Granulosa cell tumors: structural and ultrastructural analysis]. / Tumores de células de la granulosa: análisis estructural y ultraestructural.

UNLABELLED: These ovarian neoplasm derive from the ovarian stromal component constituting around the 5 to 12% of all ovarian tumors. OBJECTIVE: To examine the histopathological and ultrastructural morphologic characteristic of the neoplastic cells and the patognomonic element of these tumors: Call Exner's Bodies MATERIALS AND METHODS: The materials corresponded to 2 women of 52 and 55 years. The syntomatology was abdominal tumor that went in increase. The materials were fractioned for the histopathological conventional study and for ultrastructural analysis. For this last one, they were fixed in Karnovsky, refix in osmio and included in Araldita. RESULTS: By means of the different observations it was determined in both cases the nuclear atipia, indentations nuclei and prominent nucleoli. In one of the cases the presence of Bodies of Call-Exner was detected, and ultrastructurally was compound by whirled fibrils and amorphous material, with dense structures electron to its around. It was interest the infiltrated of plasmatic cells around the tumors cells. These neoplasms are of interest due to their impredictible behavior and to the hormonal production that can originate alterations in other organs of the genital apparatus.

Tumores de células de la granulosa: análisis estructural y ultraestructural. / [Granulosa cell tumors: structural and ultrastructural analysis]

These ovarian neoplasm derive from the ovarian stromal component constituting around the 5 to 12

of all ovarian tumors. OBJECTIVE: To examine the histopathological and ultrastructural morphologic characteristic of the neoplastic cells and the patognomonic element of these tumors: Call Exners Bodies MATERIALS AND METHODS: The materials corresponded to 2 women of 52 and 55 years. The syntomatology was abdominal tumor that went in increase. The materials were fractioned for the histopathological conventional study and for ultrastructural analysis. For this last one, they were fixed in Karnovsky, refix in osmio and included in Araldita. RESULTS: By means of the different observations it was determined in both cases the nuclear atipia, indentations nuclei and prominent nucleoli. In one of the cases the presence of Bodies of Call-Exner was detected, and ultrastructurally was compound by whirled fibrils and amorphous material, with dense structures electron to its around. It was interest the infiltrated of plasmatic cells around the tumors cells. These neoplasms are of interest due to their impredictible behavior and to the hormonal production that can originate alterations in other organs of the genital apparatus.

Mesangial nephropathy in Sjögren's syndrome.

We describe a 36-year-old woman with Primary Sjögren's Syndrome (PSS). Purpura, corneal perforation, metabolic acidosis, decreased glomerular filtration, hypokalemia, hyposthenuria, and polyuria were present. Chronic renal insufficiency and renal tubular acidosis type I were diagnosed. Kidney biopsy revealed mesangial glomerulonephritis, interstitial nephritis, and tubular atrophy. Replacement treatment with saliva, tears, and potassium citrate was started. She was given prednisone and cyclophosphamide. This would be the first description of PSS, mesangial glomerulonephritis, and chronic renal insufficiency.

[Caroli's disease: congenital cystic and segmentary dilatation of the intrahepatic bile ducts]. / Enfermedad de Caroli: dilatación quística congénita y segmentaria de las vías biliares intrahepáticas.

Congenital cystic segmentary dilatation of the intrahepatic biliary ducts is a rare disease. Although several cases has been described in medical literature, its occurrence such as it was originally referred is exceptional. Some cases coexist with congenital hepatic fibrosis and portal hypertension. A characteristic phenomenon is the formation of stones and canalicular infection. In this article, three cases of Caroli disease (females, 57, 53 and 58 years old) are described. Case n 1 was a complex malformation including: a) cystic and segmentary dilatations of the intrahepatic biliar ducts; b) intra and extrahepatic lithiasis and recurrent infections; c) fusion of the choledocus and gallbladder in a common sac; d) hepatic cavernosus hemangioma and a supernumerarious lobe. Case n 2 showed: a) cystic and segmentary dilatation of the intrahepatic biliar ducts; b) portal fibrosis; c) polycystic kidneys; d) portal hypertension. Case n 3 showed: a) cystic and segmentary dilatation of the intrahepatic biliar ducts; b) portal fibrosis; c) polycystic kidneys and spleen; d) portal hypertension. Prognostic of this patients is variable and depends on the recurrent infections and the coexistence of other malformations which are frequently severe. Surgery is the only treatment for the disease although there are no definite conclusions concerning the long-term results.

Enfermedad de Caroli: dilatación quística congénita y segmentaria de las vías biliares intrahepáticas. / [Carolis disease: congenital cystic and segmentary dilatation of the intrahepatic bile ducts]

Congenital cystic segmentary dilatation of the intrahepatic biliary ducts is a rare disease. Although several cases has been described in medical literature, its occurrence such as it was originally referred is exceptional. Some cases coexist with congenital hepatic fibrosis and portal hypertension. A characteristic phenomenon is the formation of stones and canalicular infection. In this article, three cases of Caroli disease (females, 57, 53 and 58 years old) are described. Case n 1 was a complex malformation including: a) cystic and segmentary dilatations of the intrahepatic biliar ducts; b) intra and extrahepatic lithiasis and recurrent infections; c) fusion of the choledocus and gallbladder in a common sac; d) hepatic cavernosus hemangioma and a supernumerarious lobe. Case n 2 showed: a) cystic and segmentary dilatation of the intrahepatic biliar ducts; b) portal fibrosis; c) polycystic kidneys; d) portal hypertension. Case n 3 showed: a) cystic and segmentary dilatation of the intrahepatic biliar ducts; b) portal fibrosis; c) polycystic kidneys and spleen; d) portal hypertension. Prognostic of this patients is variable and depends on the recurrent infections and the coexistence of other malformations which are frequently severe. Surgery is the only treatment for the disease although there are no definite conclusions concerning the long-term results.